Patient Involvement During a Pathway of Home-Based Reablement for Older Persons: A Longitudinal Single-Case Study

Area of Science:

• Gerontology
• Rehabilitation Science
• Health Services Research

Background:

• Home-based reablement is a growing model for supporting older adults at home.
• This approach aims to prolong independent living and reduce institutionalization.
• User involvement and co-creation are crucial for high-quality reablement services.

Purpose of the Study:

• To investigate user involvement and participation with healthcare professionals during home-based reablement.
• To understand the dynamics of patient engagement throughout the reablement process.

Main Methods:

• A longitudinal, instrumental single-case study design.
• Followed one 85-year-old female patient over a six-week reablement period.
• Collected data at goal-mapping, implementation, and post-reablement evaluation phases.

Main Results:

• Goal-mapping involved provider-led dialogue and patient-defined goals.
• Implementation highlighted the home as a preferred setting, limited patient influence on organizational factors, and the importance of participation for motivation.
• Evaluation revealed patient understanding as a prerequisite, motivation influenced by 'weak paternalism,' and self-determination linked to clear communication.

Conclusions:

• Patient involvement in reablement is a co-creation process, fostering engagement, motivation, and influence.
• Healthcare providers should respect patients' contextual knowledge and avoid excessive control.
• Effective home-based reablement requires balancing professional guidance with patient autonomy and clear communication.